Chapter 13: Looking for Dr Right

A physician is judged by the three As: Ability, Availability and Affability - Paul Rezniknoff

The perfect doctor would treat you as an intelligent person, have plenty of time, as well as infinite wisdom, charge low fees, be totally honest yet compassionate, have a conveniently located clinic and understand your emotional as well as medical problems. While you may never find such a doctor, you need to keep your picture of your ideal doctor in your mind when you are looking for the physician of your choice.

First of all, you need to find a primary-care doctor; i.e., someone who will provide medical care for your whole family; carry out regular checkups; and treat common illnesses. Such a doctor is a usually a general practitioner ( also known as a family physician in todays trendy world) , or a general physician . Women may prefer a gynecologist, and for your children you may choose to go to a pediatrician. A primary care doctor is trained to recognize common health problems in the patient as a whole; in other words, his "specialty" is comprehensive care of a patient, either on a short or long-term basis.

Ideally, a primary care doctor can offer you the following benefits:

• A good starting point in the healthcare system. Whatever your concern or problem may be, your primary care doctor will either be able to either treat it or determine precisely when and where to send you for specialized help. In either case, you have the distinct advantage of a physicians expertise, and any trips through the medical maze will be less confusing for you...and less of a hassle.
• Preventive healthcare. Your primary care doctor can help you with disease prevention, as well as prompt intervention during any illness.
• Continuity of care. You and your doctor can develop and sustain an on going health partnership. He will get to know your concerns, and you wont have to repeat your history each time you fall ill or need treatment. Your primary care doctor will know you as well as any chronic problems or potential troubles you may be facing. He well also be familiar with your family history.
• One stop shopping. You can consult the same doctor for a variety of conditions, and often, he can treat both you and your family. Your family doctor can take you and your family through pregnancy, childbirth and childcare; instilling the concept of good health at an early age.
• Lower cost and convenience. Primary care doctors generally serve large populations of patients, so they encounter and become familiar with managing the most common medical maladies. They have been trained to diagnose and treat a wide range of conditions cost- effectively. And, in most cases, its easier to gain asses to a primary care doctor than a specialist, since general practices are usually geared up for maximum efficiency.

Your primary-care physician should be someone who will coordinate and oversee your overall medical care, referring you to a specialist only if needed. It is not usually a good idea to consult the "top" specialist for every problem, though this seems to be have become fashionable these days- for example, rushing to a neurologist for a headache such a step can actually lead to your getting poor care ! Specialists often order unnecessary tests (which could be expensive and painful) to rule out rare diseases (after all, they are specialists, and they cannot afford to overlook any possibility, however, remote it may be, while making a diagnosis !).

The best time to find a doctor is when you dont need one! This statement may seem paradoxical, but finding the right doctor when you are ill becomes much more difficult, because of the stress of the illness - as well as the pressure of time. Ask your friends for recommendations. A good source of referrals can be nurses and other paramedical staff. If you have a friend who is a doctor, seek his advice as well.

During the first consultation, not only should the doctor get to know you and your medical problems by examining you, but you should also get to know a lot about him. Such a initial assessment is important in answering the following vital questions: Are you comfortable with him? Does he explain the details properly? Does he use relevant teaching aids? Does he ask for your views? Does he listen to you carefully?

While looking for the ideal doctor beware of quacks! While many of us tend to be overawed by a long list of alphabets behind the doctors name, you need to remember that not all of them are legitimate degrees. For example, many doctors will use the embellishments FICA (USA) and FRSH (London) to give the impression that they have been trained abroad. These acronyms are not qualifications- they merely indicate memberships in a society abroad, which are open to anyone- even a barber- on payment of a nominal fee, can acquire such memberships!

Useful criteria to consider while selecting a doctor are as follows:

• Is the location of the doctors clinic important? (in other words, How far do I have to travel to see the doctor? Is it convenient for me? Is there parking space?)
• Is the hospital to which the doctor admits patients important to me?
• Are factors such as the age, sex, race, and religion of the doctor important?
• Do I prefer a solo consultation or a group practice?
• Do I have to choose a doctor who is covered by my insurance plan?
• Is the doctor duly qualified and in which field? For example, a patient with a heart problem may prefer to see a cardiologist, rather than a general physician.
• What days/hours does the doctor see patients? Are the timings convenient to me ?
• Does the doctor ever make house calls?
• How much in advance do I have to make appointments?
• What is the length of an average visit?
• In case of an emergency, how fast can I see the doctor?
• Who takes care of patients after hours or when the doctor is away? At this stage, one may well pose the question: what are the attributes of a perfect doctor? In my opinion, a perfect doctor is one who:
• is respectful and treats you with dignity;
• makes you feel welcome;
• treats more than the symptoms;
• recognizes the expertise of the patient;
• listens to you, explains the relevant facts, asks you questions and answers your questions;
• makes home visits if you require them, or arranges for another doctor to visit you after hours;
• uses pictures and diagrams to explain complex medical terms;
• explains everything, including diagnosis, procedures, treatment and what you can expect in the future;
• is easy to talk to and gives you clear - cut information;
• is open to discussion about alternative systems and is willing to refer you to say, a natural therapist;
• is interested in you, is down-to-earth and treats you as an equal;
• prescribes medication that you can afford;
• fits you in if you are really sick despite a tight schedule ;
• is up-to-date with the relevant information;
• refers to various sources (e.g., books, journals, internet )to clarify information;
• refers you to an appropriate specialist when required;
• refers you to other support services or self-help groups;
• phones back when additional information or tests results are obtained; and
• gives adequate consultation time.

In contrast, a bad doctor is one who:

• Does not value your time, and makes you wait interminably on a routine basis
• Is more interested in treating your reports than in treating you
• Does not spend enough time with you
• Seems to be too busy and rushed all the time
• Orders tests whether or not they are needed
• Does not explain your options to you
• Discourages questions or refuses to answer them
• Promises too much.
• Makes remarks like "thats my secret."
• Doesnt explain clearly what he is doing during treatment. Sometimes, if you are a victim of a rare or complex problem, you may need to find a " Doctors Doctor " i.e. the best doctor in the city, country , or the world for your particular problem. How do you go about locating such a doctor?

Germany, you will find a competent doctor - you need to do your homework thoroughly before making the trip!

In order to feel good about your medical care, you should feel good about your doctor, too. In this context,

Ask yourself the following questions in order to evaluate your physician:

• Does your doctor listen to you and answer all your questions about the causes and treatment of your medical problems, or is he vague, impatient or unwilling to answer them?
• Are you comfortable with your doctor? Can you openly discuss your inner most feelings and talk about intimate personal matters , including sexual and emotional problems?
• Does your doctor take a thorough history, asking for relevant factors about past physical and emotional problems, family medical history, medications you are taking and other matters affecting your health?
• Does your doctor address the root causes of your medical problems or does he merely prescribe medicine to treat the symptoms?
• Is your doctor well-groomed ? A doctor who cannot be bothered to take care of how he looks may not look after you carefully either !
• Does your doctor smoke? ( if yes, this should be a black mark against him !)
• Are you satisfied with the doctors stand-in when he or she is unavailable?
• Do you feel at ease while asking your doctor questions that may sound "silly"?
• Does your doctor explain complex medical jargon in simple terms?
• Are the office staff members friendly? Do they listen to you patiently?
• Does your doctor answer your telephone calls promptly?
• Are you usually kept waiting for a long time even if you have fixed an appointment before hand?
• Does the doctor have hospital privileges at a respected medical institution?

If you are not satisfied with the answers to the proceeding questions, discuss your concerns with your doctor. Even after this discussion if you are still not satisfied, you should consider looking for another doctor.

changing doctors is never easy, because, over a period of time you do build up a personal relationship with your doctor.

However, you should consider changing doctors if you strongly feel that :

• the doctor is incompetent ( i.e., he has ignored obvious symptoms, missed a diagnosis, prescribed the wrong drug, or cant get to the bottom of your problem);
• the doctor does not communicate with you effectively ( i.e., his explanations are not in lay persons language or no time is given to you to ask questions and bring up related problems);
• the doctor does not pay attention to your needs and concern
• you have lost confidence in the doctors skill and ability.
• you find the doctor is too inconsiderate ( i.e., he makes you wait a long time for an appointment, he fails to return your phone calls, he does not provide clinic time during evening or weekend hours ); and
• your doctor is too expensive.

In the final analysis, remember that the most reliable test for a doctors suitability for you is your own gut instinct - after all, if you dont feel comfortable with your doctor, you are not likely to be able to work well together in your health care partnership with him ! On the other hand, if you have faith in his abilities and can trust him that he will do his best for you, you are likely to get excellent medical care !